PMS32 - ASSESSING DIRECT AND INDIRECT HEALTH SYSTEM COSTS OF THE BUILD BETTER BONES WITH EXERCISE PILOT TRIAL
VALUE IN HEALTH(2018)
摘要
The Build Better Bones with Exercise (B3E) pilot trial evaluated the effects of home exercise on community-dwelling older women with vertebral fractures. The objective of this preliminary economic analysis was to describe direct and indirect health system costs of B3E study participants. he B3E study participants were randomized in a 1:1 ratio to a 12-month home exercise program or equal attention control group. Clinical and health system resources such as adverse events (AEs), allied health visits, caregiver time, lost productivity, medical equipment, medications, out-of-pocket costs, and physician visits and tests were collected during monthly phone calls by a blinded research assistant and from daily diaries completed by participants. Quality of life (QoL) information was collected via EQ-5D at baseline, 6 and 12 months. Unit costs (2018 CAD) were applied to health system resources to calculate total, median±standard deviation [SD] and minimum-maximum (min-max) costs of the intervention and control groups, as well as the median cost per patient. The incremental cost-effectiveness ratio (ICER) between the two groups was also calculated. The study included 141 women (mean age=76±6.40y for intervention, 77±7.28y for control) and overall total costs were $598,811 and $548,853, respectively. The top three cost drivers were caregiver time ($250,268 and $240,811), medications ($151,000 and $122,144) and adverse events ($58,807 and $71,981). The mean cost per intervention patient was $8,434±$9,988 (median=$4,123, min-max=$279-$56,842), and the mean cost per control patient was $7,841±$9,718 (median=$4,272, min-max=$0-$50,396). The mean EQ-5D index score per patient was 0.81±0.11 (median=0.81, min-max=0.54-1) and 0.79±0.13 (median=0.80, min-max= 0.33-1) respectively. The ICER was calculated to be $1,299 more per patient for the intervention group. Results from this preliminary study of 141 women in the B3E study indicate a variety of health resources are being utilized over a 12-month period.
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关键词
better bones,exercise pilot trial,indirect health system costs
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